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US · guidance

CMS Pub. 100-04, ch. 18, § 90.3.1

Modifier Requirements for Pre-diabetes

activein force · 2026-08-25 – presentas-observed

A claim that is submitted for diabetes screening and the beneficiary meets the definition of pre-diabetes shall be

submitted in the following manner:

The line item shall contain 82497, 82950 or 82951 with a diagnosis code of V77.1 (if ICD-9-CM is applicable) or, if,

ICD-10-CM is applicable, diagnosis code Z13.1. In addition, modifier “TS” (follow-up service) - shall be reported on

the line item.

History

(Rev. 3329, Issued: 08-14-15, Effective: 01-01-12, Implementation: 09-14-15)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
ac87e9d4252267eb02c9b7179644aafb13122642191c141770f30ae756400f6c
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